Purpose
To investigate the clinical outcomes and radiologic evaluation of an all-arthroscopic
Latarjet procedure with modified button fixation.
Methods
Patients who received all-arthroscopic Latarjet procedure with modified suture button
fixation between September 2015 to September 2016 were retrospectively reviewed. Indications
for surgery were recurrent anterior shoulder dislocation with any 1 of these 3 conditions:
glenoid defect >15%, contact-sport athlete, or failure after Bankart repair. Inclusion
criteria included cases who received this surgery. Clinical outcomes were evaluated
by University of California Los Angeles, ASES and Rowe score with a minimal follow-up
of 3 years. Radiologic assessment on 3D computed tomography scan was performed preoperatively
and postoperatively at different time points. Complications were also recorded.
Results
A total of 30 patients were eventually included in this study. The mean follow-up
time was 38.0 ± 2.5 months. There were 25 patients who performed contact sports. Of
them, 10 patients were without glenoid defect >15% or failed Bankart repair. The remaining
20 patients had glenoid defect >15%, including 2 failed Bankart cases. Ten patients
had glenoid defect < 13.5%, and the rest 20 patients had > 13.5%. UCLA, American Shoulder
and Elbow Surgeons, and Rowe score significantly improved during follow-up, and the
improvement exceeded MCID for all patients. No severe complications were noted. In
total, 86.7% of the graft positioning was measured as flush and 13.3% as medial. The
bone union rate was 96.7% at 3 months postoperatively and at final follow-up. The
remodeling process for the restoration of the normal anatomy of the lower part of
glenoid was noted.
Conclusions
All-arthroscopic Latarjet with modified suture button fixation can achieve stable
fixation of the coracoid, good clinical outcomes (all patients with improvement exceeding
MCID), low complications rate. Furthermore, the bone remodeling process contributes
to the recovery of the normal anatomy of anteroinferior glenoid.
Study Design
Case series; Level of evidence, 4.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ArthroscopyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- What is a Bristow-Latarjet procedure? A review of the described operative techniques and outcomes.Bone Joint J. 2016; 98-B: 1208-1214
- History of shoulder instability and subsequent injury during four years of follow-up: A survival analysis.J Bone Joint Surg Am. 2013; 95: 439-445
- Operative versus nonoperative treatment after primary traumatic anterior glenohumeral dislocation: Expected-value decision analysis.J Shoulder Elbow Surg. 2011; 20: 1087-1094
- The outcomes and surgical techniques of the latarjet procedure.Arthroscopy. 2014; 30: 227-235
- Complications and re-operations after Bristow-Latarjet shoulder stabilization: A systematic review.J Shoulder Elbow Surg. 2013; 22: 286-292
- Long-term results after arthroscopic shoulder stabilization using suture anchors: An 8- to 10-year follow-up.Am J Sports Med. 2011; 39: 2396-2403
- The arthroscopic Latarjet procedure for the treatment of anterior shoulder instability.Arthroscopy. 2007; 23: 1242.e1-1242.e5
- Complications associated with open coracoid transfer procedures for shoulder instability.J Shoulder Elbow Surg. 2012; 21: 1110-1119
- Comparative systematic review of fixation methods of the coracoid and conjoined tendon in the anterior glenoid to treat anterior shoulder instability.Orthop J Sports Med. 2019; 7 (2325967118820539)
- Arthroscopic Latarjet procedure: Is optimal positioning of the bone block and screws possible? A prospective computed tomography scan analysis.J Shoulder Elbow Surg. 2016; 25: 69-77
- Glenohumeral dislocation arthropathy: Etiology, diagnosis, and management.J Am Acad Orthop Surg. 2019; 27: 227-235
- A guided surgical approach and novel fixation method for arthroscopic Latarjet.J Shoulder Elbow Surg. 2016; 25: 78-89
- Arthroscopic Latarjet: Suture-button fixation is a safe and reliable alternative to screw fixation.Arthroscopy. 2019; 35: 1050-1061
- Modified arthroscopic Latarjet procedure: Suture-button fixation achieves excellent remodeling at 3-year follow-up.Am J Sports Med. 2020; 48: 39-47
- Arthroscopic Latarjet procedure with double-button fixation: Short-term complications and learning curve analysis.J Shoulder Elbow Surg. 2018; 27: e189-e195
- Latarjet with cortical button fixation is associated with an increase of the risk of recurrent dislocation compared to screw fixation.Knee Surg Sports Traumatol Arthrosc. 2020; 28: 2354-2360
- Double-screw and quadruple-button fixation for the glenoid: Latarjet versus bone block applications.JSES Int. 2020; 4: 780-785
- Early follow-up of arthroscopic Latarjet procedure with screw or suture-button fixation for recurrent anterior shoulder instability.Orthop Surg. 2020; 12: 1350-1361
- Arthroscopic double-button Latarjet: Two-thirds of bone block healed at 90 days.Knee Surg Sports Traumatol Arthrosc. 2021; 29: 136-142
- Biomechanical comparison of screw fixation versus a cortical button and self-tensioning suture for the Latarjet procedure.Orthop J Sports Med. 2018; 6 (2325967118777842)
- Cortical suture button fixation vs. bicortical screw fixation in the Latarjet procedure: A biomechanical comparison.J Shoulder Elbow Surg. 2020; 29: 1470-1478
- Medical conditions affecting sports participation. American Academy of Pediatrics Committee on Sports Medicine and Fitness.Pediatrics. 1994; 94: 757-760
- An Arthroscopic "Inlay" Bristow procedure with suture button fixation for the treatment of recurrent anterior glenohumeral instability: 3-year follow-up.Am J Sports Med. 2020; 48: 2638-2649
- Optimization of bone-block positioning in the Bristow-Latarjet procedure: A biomechanical study.Orthop Traumatol Surg Res. 2014; 100: 509-513
- Graft position and fusion rate following arthroscopic.Latarjet. Knee Surg Sports Traumatol Arthrosc. 2016; 24: 507-512
- Fate of coracoid grafts after the Latarjet procedure: Will be analogous to the original glenoid by remodelling.Knee Surg Sports Traumatol Arthrosc. 2018; 26: 926-932
- Diagnosis and management of humeral head bone loss in shoulder instability.Am J Sports Med. 2012; 40: 2633-2644
- Pathologic changes associated with shoulder dislocations. Arthroscopic and physical examination findings in first-time, traumatic anterior dislocations.Am J Sports Med. 1997; 25: 306-311
- Arthroscopic Latarjet procedure combined with Bankart repair: A technique using 2 cortical buttons and specific glenoid and coracoid guides.Arthrosc Tech. 2018; 7: e313-e320
Article info
Publication history
Published online: January 27, 2022
Accepted:
January 12,
2022
Received:
August 23,
2021
Footnotes
The authors report the following potential conflicts of interest or sources of funding: This study was supported by the National Key Research and Development Program of China (2018YFF0301100), and National Natural Science Foundation of China (No. 82172423). Full ICMJE author disclosure forms are available for this article online, as supplementary material.
All surgeries were performed by Guoqing Cui.
This study was performed at Department of Sports Medicine, Peking University Third Hospital.
Identification
Copyright
© 2022 by the Arthroscopy Association of North America
